How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $602.56 | Professional | None | $446.68 | $512.86 | $602.56 |
Ambetter Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $891.25 Typical High $891.25 | Facility | None | $426.58 | $891.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $891.25 Typical High $1,698.24 | Professional | None | $870.96 | $891.25 | $1,698.24 |
Medica Setting Facility Modifier None Typical Low $512.86 Median $870.96 Typical High $3,630.78 | Facility | None | $512.86 | $870.96 | $3,630.78 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $630.96 | Professional | None | $302.00 | $398.11 | $630.96 |
Midlands Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,698.24 | Professional | None | $870.96 | $870.96 | $1,698.24 |
Midlands Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Midlands Setting Professional Modifier None Typical Low $1,122.02 Median $1,698.24 Typical High $2,187.76 | Professional | None | $1,122.02 | $1,698.24 | $2,187.76 |
United Setting Facility Modifier None Typical Low $426.58 Median $794.33 Typical High $794.33 | Facility | None | $426.58 | $794.33 | $794.33 |
United Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $524.81 | Professional | None | $288.40 | $398.11 | $524.81 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $257.04 Typical High $302.00 | Professional | 52 · Reduced service | $204.17 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $102.33 Typical High $120.23 | Professional | 53 · Discontinued | $81.28 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $77.62 Typical High $89.13 | Professional | 55 · Aftercare only | $61.66 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $51.29 Typical High $60.26 | Professional | 56 · Pre-op care only | $40.74 | $51.29 | $60.26 |
Where Nebraska sits
The same service costs 3.8 times more in Hawaii than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Nebraska· 15th of 51
$617
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.